The size of pelvic hematoma can be a predictive factor for angioembolization in hemodynamically unstable pelvic trauma

Hak-Jae Lee; Hyo-Keun No; Nak-Joon Choi; Hyun-Woo Sun; Jae-Suk Lee; Yoon-Joong Jung; Suk-Kyung Hong

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자료유형: 학술저널

저자정보: Hak-Jae Lee (University of Ulsan College of Medicine) Hyo-Keun No (Korean Army Academy Hospital) Nak-Joon Choi (University of Ulsan College of Medicine) Hyun-Woo Sun (University of Ulsan College of Medicine) Jae-Suk Lee (University of Ulsan College of Medicine) Yoon-Joong Jung (University of Ulsan College of Medicine) Suk-Kyung Hong (University of Ulsan College of Medicine)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.98 No.3

발행연도: 2020.3

수록면: 146 - 152 (7page)

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Purpose: Unstable pelvic fracture with bleeding can be fatal, with a mortality rate of up to 40%. Therefore, early detection and treatment are important in unstable pelvic trauma. We investigated the early predictive factors for possible embolization in patients with hemodynamically unstable pelvic trauma.
Methods: From January 2011 to December 2013, 46 patients with shock arrived at a single hospital within 24 hours after injury. Of them, 44 patients underwent CT scan after initial resuscitation, except for 2 who were dead on arrival. Nine patients with other organ injuries were excluded. Seventeen patients underwent embolization. A single radiologist measured the width (longest length in axial view) and length (longest length in coronal view) of pelvic hematoma on CT scans. Demographic, clinical, and radiological data were reviewed retrospectively.
Results: Among 35 patients with hemodynamically unstable pelvic fracture, 22 (62.9%) were men. Width (P = 0.002) and length (P = 0.006) of hematoma on CT scans were significantly different between the embolization and nonembolization groups. The predictors of embolization were width of pelvic hematoma (odds ratio [OR], 1.07; P = 0.028) and female sex (OR, 10.83; P = 0.031). The cutoff value was 3.35 cm. More embolization was performed (OR, 12.00; P = 0.003) and higher mortality was observed in patients with hematoma width >3.35 cm (OR, 4.96; P = 0.048).
Conclusion: Patients with hemodynamically unstable pelvic trauma have a high mortality rate. CT is useful for the initial identification of the need for embolization among these patients. The width of pelvic hematoma can predict possible embolization in patients with unstable pelvic trauma.

#Bone fractures #Hematoma #Therapeutic embolization #X-ray computed tomography

참고문헌 (25)

참고문헌 신청

El-Haj M / 2013 / Outcome of angiographic embolisation for unstable pelvic ring injuries : factors predicting success / Injury 44:1750~1755

Hymel A / 2017 / Selective versus nonselective embolization versus no embolization in pelvic trauma : a multicenter retrospective cohort study / J Trauma Acute Care Surg 83:361~367

Tanizaki S / 2014 / Time to pelvic embolization for hemodynamically unstable pelvic fractures may affect the survival for delays up to 60 min / Injury 45:738~741

Tesoriero RB / 2017 / Angiographic embolization for hemorrhage following pelvic fracture: is it “time” for a paradigm shift? / J Trauma Acute Care Surg 82:18~26

White CE / 2009 / Haemodynamically unstable pelvic fractures / Injury 40:1023~1030

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